“…The main cause of these poor outcomes include incorrect sizing of implants, incorrect indications for surgery and malpositioning of the implant (14,18). An implant must be placed accurately at the midline for optimum function, durability and clinical outcomes (8,10,11,14). If the positioning of the device is not correct, complications can arise such as coronal tilt and scoliosis, abnormal loading of the facet joints and adjacent disc degeneration (14).…”